394 '/'k' Uterus 



branches coming with the ovarian and uterine arteries (aortic and iliac 

 plexuses) ; important twigs also come from the third and fourth 

 sacral nerves. 



When an examination is made per vaginam but a few days after 

 conception the uterus is found hot and turgid as if formed of erectile 

 tissue. The finger may also feel the enlarged body of the uterus 

 through the front of the vagina, and the os is ' soft and cushiony.' The 

 surface of the abdomen becomes flatter and the navel is deepened ; 

 hence the proverb, ; En ventre plat, enfant il-y-a? 



Os and cervix at third month Os and cervix at eighth month, 



of pregnancy. 



In the third month the abdomen shows enlargement ; in the fifth 

 month the uterus can be felt above the pubes, perhaps halfway to the 

 navel. There is no confirmation of the supposition that ' quickening ' 

 is the result of a sudden ascent of the uterus. With advancing preg- 

 nancy souffles and pulsations are heard, and the movements of the 

 foetus may be felt and seen through the abdominal wall. 



A few days before parturition the foetus sinks towards the pelvis, 

 preparatory to delivery. 



The pregnant uterus may press against the renal veins, or may in- 

 directly irritate the kidneys, so that albuminuria occurs ; the legs, vulva, 

 hands, and face become cedematous, and unemic poisoning may be 

 obviated only by producing miscarriage. By pressure on the iliac veins 

 the haemorrhoidal plexus becomes congested and piles appear, and the 

 saphenous veins become varicose. On account of irritation of the 

 lumbar and sacral nerves, neuralgias and cramps occur. These con- 

 ditions may be relieved by recumbency. The bladder is apt to be 

 irritated and the rectum obstructed. 



Development. Early in foetal life an efferent duct descends from 

 the ovary (which is then near the kidney) ; the outer part of the duct 

 becomes the Fallopiair tube, whilst the part nearer the middle line 

 fuses with its fellow of the opposite to become the uterus. In some 

 of the lower animals the fusion of the tubes is less perfect than in the 

 human subject, so that the uterus remains bifurcated at the fundus 

 iitcnisbicornis. The cavity of the normal human uterus (p. 390) shows 



